• Journal of Korean Foot and Ankle Society
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• v.4 no.1
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• pp.44-47
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• 2000

Freiberg's infarction involving the fifth metatarsal head is very rare condition. The authors experienced a case of avascular necrosis of the fifth metatarsal head and base of the proximal phalanx in a 27-year-old female patient. Involved bones were excised and internally fixed with 2 K-wires after autogenous cancellous bone grafting. Pain was relieved, and an excellent clinical result was obtained at the follow-up examination six months after the surgery.

• 대한족부족관절학회:학술대회논문집
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• 2008.11a
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• pp.13-13
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• 2008

• Journal of the Korean Arthroscopy Society
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• v.11 no.1
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• pp.59-62
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• 2007

Freiberg disease is a relatively rare osteochondrosis of metatarsal head, which usually involves the 2nd metatarsal of adolescent females. Various open surgical treatments have been recommended; arthrotomy and removal of loose body, dorsiflexion osteotomy and resection of the metatarsal head. Arthroscopic treatment for Freiberg disease has a merit of shortening the recovery period and reducing the postoperative stiffness. We report a case of early stage Freiberg disease treated with metatarsophalangeal arthroscopic excision of loose body and debridement of the 2nd metatarsophalangeal joint.

• Journal of Korean Foot and Ankle Society
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• v.1 no.1
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• pp.5-11
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• 1997

Multiple surgical procedures for the correction of hallux valgus have been described. The surgical algorithm is based on the degree of deformity, patient's age, and the presence or absence of arthritis. It is known that the role of an isolated distal soft-tissue procedure is limited and the procedure must be used in conjunction with the proximal metatarsal osteotomy to correct most hallux valgus. We reviewed retrospectively the clinical & radiological results of distal soft-tissue procedure with or without proximal metatarsal osteotomy, performed in 18 patients (29 cases ) who had mild to moderate degrees af hallux valgus deformity. The results were as follows : In 20 cases with isolated soft-tissue procedures, the preoperative hallux valgus angle (HV) averaged 30.6 degrees and the postoperative HV averaged 7.3 degrees. The preoperative intermetatarsal angle (IM) averaged 12.5 degrees and postoperative IM averaged 10.4 degrees. 2. In 9 cases with the proximal metatarsal osteotomy added, the preoperative HV averaged 32.5 degrees, and the postoperative HV averaged 8.0 degrees. The preoperative IM averaged 12.5 degrees, and postoperative IM averaged 10.1 degrees. 3. There was no significant difference of loss of correction, presence of complication, patients own satisfaction, between two groups. In conclusion, as for the patients with mild to moderate degrees of hallux valgus deformities, the clinical and radiological results following distal soft tissue procedure and proximal metatarsal osteotamy are not proved to be superior to those following isolated soft-tissue procedures.

• Journal of Korean Foot and Ankle Society
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• v.8 no.2
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• pp.117-120
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• 2004

Purpose: The purpose of this study was to evaluate the effect and short-term results of the modified Mau osteotomy designed by the author. Materials and Methods: Seventeen feet treated with newly designed osteotomy from 2003 to 2004 were included. We performed metatarsal osteotomy and distal soft tissue procedure on 17 feet (12 patients) and additional Akin osteotomy on 6 feet (4 patients). An oblique osteotomy was made from the neck in the dorsum, aiming proximal to the base of the first metatarsal with vertical short arm on the base. We performed long arm of osteotomy parellel to the acrylic plate which was supposed as ground plane. Preoperative radiographs and follow up radiographs at three month were used for radiologic evaluation. Results: Mean hallux valgus angle was $43.6^{\circ}$ and mean intermetatarsal angle was $20.4^{\circ}$ on preoperative weight bearing radiograph. Mean amount of correction of the hallux valgus angle was $37.5^{\circ}$ and intermetatarsal angle was $14.2^{\circ}$ at three months after operation. There was no fixation loss or malunion, and the clinical result was subjectively exellent. Conclusion: More proximal rotational axis can achieve sufficient intermetatarsal angle correction, and vertical arm can provide more stable contact. So this newly modified Mau osteotomy was considered as a good alternative procedure in the treatment of severe hallux valgus.

• Korean Journal of Applied Biomechanics
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• v.18 no.4
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• pp.59-65
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• 2008

The purpose of this study was to investigate the shift of COP pathway and the plantar foot pressure among level walking and stairs and ramp climbing in young and elderly people. Plantar foot pressure was measured by MatScan system(Tekscan, USA). Statistical analysis was used One-way ANOVA to know the characteristics of peak plantar pressure during walking with different the facilities. In young adults, COP pathway during stairs climbing was slightly shorten and trended to abduct at forefoot. COP pathway during ramp climbing was also shorten but trend to adduct at forefoot. Peak plantar pressure of 2-3 metatarsal head and heel during ramp climbing was more decreased than level walking. In elderly people, COP pathway during stairs climbing was more shorten and abducted than leve walking and COP pathway during ramp climbing was more unstable than level walking. Peak plantar pressure of first metatarsal head increased at stair climbing and decreased at ramp climbing. That of second metatarsal head and heel was more decreased at ramp climbing. Conclusionally, Peak plantar pressures of each foot region generally increased and more changed during ramp climbing.

• Journal of the Korean Orthopaedic Association
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• v.54 no.1
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• pp.59-66
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• 2019

Purpose: Several radiologic reference lines have been used to evaluate individuals with a clubfoot but there is no consensus as to which is most reliable. The aim of this study was to identify which radiologic parameters have relevance to the predictability of additional surgery after Ponseti casting on clubfoot and the effect of clubfoot treatments that contain Ponseti casting and additional surgery. Materials and Methods: A total of 102 clubfeet (65 patients, 37 bilateral) were reviewed from 2005 to 2013. The patients were divided into two groups (Group A, those for whom the result of the Ponseti method was successful and did not require additional surgery; and Group B, those for whom the result of the Ponseti method was unsuccessful and required additional surgery), and the following parameters were measured on the plain radiographs: i) talo-calcaneal angle on the anteroposterior and lateral view, ii) talo-1st metatarsal angle on the anteroposterior view, and iii) Tibio-calcaneal angle on the lateral view with the ankle full-dorsiflexion state. Each radiograph was reviewed on two separate occasions by one orthopedic doctor to characterize the intra-observer reliability, and the averages were analyzed. Next, 20 cases were chosen using a random number table, and two orthopedic doctors measured the angle separately to characterize the interobserver reliability. Results: Groups A and B included 73 clubfeet (71.6%) and 29 clubfeet (28.4%), respectively. The initial talo-calcaneal angle and tibiocalcaneal angle in the lateral view were significantly different among the groups. In addition, inter- and intra-observer biases were not detected. The talo-1st metatarsal angle on the anteroposterior view and tibio-calcaneal angle on the lateral view were significantly different after treatment in both groups. Conclusion: Congenital clubfeet treated with the Ponseti method showed successful results in more than 70% of patients. The initial talocalcaneal angle and tibio-calcaneal angle on the lateral view were the radiologic parameters that could predict the need for additional surgical treatments. The talo-1st metatarsal angle on the anteroposterior view and tibio-calcaneal angle on the lateral view could effectively evaluate the changes in clubfoot after treatment.

• Journal of Korean Foot and Ankle Society
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• v.11 no.1
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• pp.115-119
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• 2007

Avascular necrosis of the first metatarsal head is uncommon. It is most often seen following a distal metatarsal osteotomy for hallux valgus. Although many cases may be subclinical, it is a powerful cause of failure of bunion surgery. Avascular necrosis of the first metatarsal head results in a series of events that begins with phases of avascularity; revascularization, with or without collapse; and reossification. Collapse may result in degenerative change of the metatarsophalangeal joint. We have recently experienced a case of avascular necrosis of the first metatarsal head.

• Journal of Biomedical Engineering Research
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• v.20 no.5
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• pp.587-592
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• 1999

압력측정시스템은 입각기동안 동적압력분포를 성공적으로 측정할 수 있으나 하중수용기-중간입각기, 말기입각기-전유각기의 전환기들에 대해서는 운동분석시스템을 사용하지않고는 정확한 정의가 불가능하다. 따라서 저자들은 수평자유보행 시 압력중심의 이동을 이해하기 위해서 정상적인 발을 가진 20-30대 성인남자 78명을 대상으로 동작분석과발바닥 압력측정을 동시에 수행하였다. 결과로 하중반응기-중간입각기 전환시기의 발바닥 압력중심점은 후족부와 중족부의 경계선에서 앞쪽으로 1.9$\pm$1.5frame(32$\pm$24msec)에 위치하였으며 말기입각기-전유각기 전환시기에는 중족골두 최대 압력점의 앞쪽으로 2.3$\pm$2.0 frame(38$\pm$33msec)에 위치하였다. 정상수평보행에 있어서 최초접지 순간 압력중심은 전방으로 빠르게 이동하다가 바로 급속히 감소하여 하중반응기-중간입각기의 전환시기에는 작은 속도로 이동하였다. 압력중심의 이동속도는 그 후 다시 서서히 증가하다가 전체 보행주기의 25% 전후에서 서서히 감소하여 비교적 일정하다가 말기입각기-전유각기의 전환시점에서 다시 급격한 증가를 보였다. 족부질환과 보행특성을 판단하는데 있어서 압력중심의 이동궤적은 매우 유용한 인자가 될 것으로 기대된다. 본 연구를 통해서 압력측정시스템만으로는 정의할 수 없었던 두 전환기인 하중반응기-중간입각기, 말기입각기-전유각기를 결정할 수있게 되었다.

• Journal of Korean Foot and Ankle Society
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• v.9 no.1
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• pp.59-63
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• 2005

Purpose: To present the procedure and results of dorsal wedge osteotomy fixated by bioabsorbable polyglycolide pins for the treatment of symptomatic Freiberg's disease. Materials and Methods: From January 1997 to December 2002, six patients with Freiberg's disease underwent dorsal wedge osteotomy of the metatarsal neck to bring the healthy plantar part of the metatarsal head into articulation. Bioabsorbable polyglycolide pins were used for the fixation and short-leg walking cast was applied for 4 weeks. Results: All patients returned to full daily activities without pain in three months after the operation. Radiographically, solid healing of the osteotomy was observed at average ten weeks. The active range of motion of the metatarsophalangeal joint increased by a mean gain of 30 degrees, and no complication such as displacement, osteolysis or sinus formation was observed. Conclusion: Dorsal wedge osteotomy fixated by bioabsorbable pins for patients with symptomatic Freiberg's disease is effective procedure that provides relatively early range of motion exercise and avoids second procedure for implant removal.